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Hments, and to the best of my knowledge and belief it is true, correct, and complete and includes all property required to be reported which is owned, claimed, possessed, controlled, or managed by the person named as the assessee in this statement at 12:01 a.m. on January 1, 2017. SIGNATURE OF ASSESSEE OR AUTHORIZED AGENT* DATE ᮣ BUSINESS DESCRIPTION (ߜ) Retail Wholesale Manufacturer Service / Professional Ⅺ Ⅺ Ⅺ Ⅺ NAME OF ASSESSEE OR AUTHORIZED AGENT* (typed or printed) TITLE NA.

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